title: Increased concentrations of genotype-interpreted Ca 19-9 in urine of bladder cancer patients mark diffuse atypia of the urothelium.
abstract: We investigated the use of genotype-interpreted measurements of the tumor marker Ca 19-9 in the urine of bladder cancer patients as a marker of the extent of urothelial disease. Ca 19-9 in urine (sialyl-Le(a)/creatinine ratio) was measured in 81 bladder cancer patients and correlated to T-category, histologic grade, and presence of urothelial dysplasia. As reference group, Ca 19-9 ratio was measured in urine from 21 apparently healthy individuals. The amount of sialyl-Le(a) expressed is influenced by the Lewis genotype and secretor status. Accordingly, secretor status was determined in urine by a novel ELISA method, and the Lewis genotypes of all of the individuals were determined by PCR cleavage methods. Ca 19-9 concentrations in urine were higher (P < 0.01) in bladder cancer patients than in healthy individuals and significantly (P = 0.02) higher in cancer patients with concomitant urothelial dysplasia than in those with normal urothelium. For individuals Lewis-genotyped as homozygous wild-type, Ca 19-9 concentrations in urine were higher, both in cancer patients (P = 0.06) and in healthy individuals (P = 0.004), than in the heterozygous individuals. Furthermore, nonsecretor cancer patients had higher (P < 0.01) Ca 19-9 concentrations in urine. Attention is drawn to the possibility of a general genotype interpretation of a result in clinical chemistry.
authors.affiliation: Department of Clinical Biochemistry, Skejby University Hospital, Aarhus, Denmark.
authors.forename: E M
authors.initials: EM
authors.lastname: Vestergaard
authors.forename: H
authors.initials: H
authors.lastname: Wolf
authors.forename: T F
authors.initials: TF
authors.lastname: Orntoft
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D014408:Biomarkers, Tumor / Q000652:urine; D018395:CA-19-9 Antigen / Q000652:urine*; D003404:Creatinine / Q000652:urine; D005260:Female; D005732:Gangliosides / Q000652:urine; D005838:Genotype; D006801:Humans; D007983:Lewis Blood Group Antigens / Q000652:urine; D008297:Male; D008875:Middle Aged; D001749:Urinary Bladder Neoplasms / Q000473:pathology*; D019459:Urothelium / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D005732:Gangliosides; D007983:Lewis Blood Group Antigens; C064564:sialyl Le(a) ganglioside; D003404:Creatinine